Endoscopic reposable surgical clip applier

ABSTRACT

A reposable surgical clip applier includes a handle assembly and an endoscopic assembly that is selectively connectable to and in mechanical communication with the handle assembly. The endoscopic assembly includes a shaft assembly having an outer tube defining a longitudinal axis extending therealong and a pair of transverse channels formed therein, a pusher bar slidably supported within the outer tube, and a spindle assembly slidably supported within the outer tube. A proximal portion of the pusher bar is received within the pair of transverse channels. A surface of the spindle supports a fin that is in selective engagement with a proximal portion of the pusher bar such that during a distal advancement of the spindle, the fin urges the pusher bar in a distal direction.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application claims the benefit of and priority to U.S. ProvisionalPatent Application No. 62/415,638 filed Nov. 1, 2016, the entiredisclosure of which is incorporated by reference herein.

BACKGROUND Technical Field

The technical field relates to surgical clip appliers. Moreparticularly, the present disclosure relates to endoscopic reposablesurgical clip appliers having a reusable handle assembly, at least onereusable shaft assembly, and at least one disposable clip cartridgeassembly.

Description of Related Art

Endoscopic surgical staplers and surgical clip appliers are known in theart and are used for a number of distinct and useful surgicalprocedures. In the case of a laparoscopic surgical procedure, access tothe interior of an abdomen is achieved through narrow tubes or cannulasinserted through a small entrance incision in the skin. Minimallyinvasive procedures performed elsewhere in the body are often generallyreferred to as endoscopic procedures. Typically, a tube or cannuladevice is extended into the patient's body through the entrance incisionto provide an access port. The port allows the surgeon to insert anumber of different surgical instruments therethrough using a trocar andfor performing surgical procedures far removed from the incision.

During a majority of these procedures, the surgeon must often terminatethe flow of blood or another fluid through one or more vessels. Thesurgeon will often use a particular endoscopic surgical clip applier toapply a surgical clip to a blood vessel or another duct to prevent theflow of body fluids therethrough during the procedure.

Endoscopic surgical clip appliers having various sizes (e.g.,diameters), that are configured to apply a variety of diverse surgicalclips, are known in the art, and which are capable of applying a singleor multiple surgical clips during an entry to the body cavity. Suchsurgical clips are typically fabricated from a biocompatible materialand are usually compressed over a vessel. Once applied to the vessel,the compressed surgical clip terminates the flow of fluid therethrough.

Endoscopic surgical clip appliers that are able to apply multiple clipsin endoscopic or laparoscopic procedures during a single entry into thebody cavity are described in commonly-assigned U.S. Pat. Nos. 5,084,057and 5,100,420 to Green et al., which are both incorporated by referencein their entirety. Another multiple endoscopic surgical clip applier isdisclosed in commonly-assigned U.S. Pat. No. 5,607,436 by Pratt et al.,the contents of which is also hereby incorporated by reference herein inits entirety. These devices are typically, though not necessarily, usedduring a single surgical procedure. U.S. Pat. No. 5,695,502 to Pier etal., the disclosure of which is hereby incorporated by reference herein,discloses a resterilizable endoscopic surgical clip applier. Theendoscopic surgical clip applier advances and forms multiple clipsduring a single insertion into the body cavity. This resterilizableendoscopic surgical clip applier is configured to receive and cooperatewith an interchangeable clip magazine so as to advance and form multipleclips during a single entry into a body cavity.

During endoscopic or laparoscopic procedures it may be desirable and/ornecessary to use different size surgical clips or different configuredsurgical clips depending on the underlying tissue or vessels to beligated. In order to reduce overall costs of an endoscopic surgical clipapplier, it is desirable for a single endoscopic surgical clip applierto be loadable with and capable of firing different size surgical clipsas needed.

Accordingly, a need exists for endoscopic surgical clip appliers thatinclude reusable handle assemblies, reusable shaft assemblies, anddisposable clip cartridge assemblies, with each clip cartridge assemblybeing loaded with a particularly sized clip (e.g., relatively small,relatively medium, or relatively large).

SUMMARY

The present disclosure relates to reposable endoscopic surgical clipappliers.

According to an aspect of the present disclosure, a reposable surgicalclip applier includes a handle assembly and an endoscopic assemblyselectively connectable to and in mechanical communication with thehandle assembly. The endoscopic assembly includes a shaft assemblyhaving an outer tube, a pusher bar slidably supported within the outertube, and a spindle assembly slidably supported within the outer tube.The outer tube defines a longitudinal axis extending therealong and apair of transverse channels formed therein. A proximal portion of thepusher bar is received within the pair of transverse channels. A surfaceof the spindle supports a fin that is in selective engagement with aproximal portion of the pusher bar. During a distal advancement of thespindle, the fin urges the pusher bar in a distal direction.

Each of the pair of transverse channels may define a substantiallyU-shaped profile.

In embodiments, a proximal portion of each of the pair of transversechannels may define a first portion that extends in an orthogonalorientation with respect to the longitudinal axis of the outer tube.

In embodiments, each of the pair of transverse channels may define asecond portion adjacent to the first portion that extends in a parallelorientation relative to the longitudinal axis of the outer tube.

In embodiments, each of the pair of transverse channels may define athird portion adjacent to the second portion that defines an obliqueangle with respect to the longitudinal axis of the outer tube.

The pusher bar may include a transverse pin disposed on a proximalportion thereof that is configured to slidably engage the pair oftransverse channels.

In embodiments, a proximal portion of the pusher bar may define an armforming an oblique angle with respect to a second longitudinal axisdefined by the pusher bar.

The reposable surgical clip applier may further include a biasingelement. A first end of the biasing element is coupled to the pusher barand a second end of the biasing element is coupled to the outer tubesuch that the biasing element biases the pusher bar in a proximaldirection.

In embodiments, during an initial distal advancement of the spindle, thepusher bar may translate in a horizontal direction within the secondportion of the pair of transverse channels.

In embodiments, during continued distal advancement of the spindle, thepair of transverse channels may cam the pusher bar in a direction awayfrom the longitudinal axis of the outer tube to follow the obliqueorientation of the third portion of the pair of transverse channels.

In embodiments, when the pusher bar is in a distal-most position, thefin may be disengaged from the leg of the pusher bar to permit thespindle to advance in a distal direction separate from the pusher bar.

According to another embodiment of the present disclosure, an endoscopicassembly for use with a reposable surgical clip applier includes anouter tube defining a longitudinal axis extending therealong and a pairof transverse channels formed therein, a pusher bar slidably supportedwithin the outer tube, and a spindle assembly slidably supported withinthe outer tube.

A proximal portion of the pusher bar is received within the pair oftransverse channels. A surface of the spindle supports a fin that is inselective engagement with a proximal portion of the pusher bar. During adistal advancement of the spindle, the fin urges the pusher bar in adistal direction.

Each of the pair of transverse channels may define a substantiallyU-shaped profile.

In embodiments, a proximal portion of each of the pair of transversechannels may define a first portion that extends in an orthogonalorientation with respect to the longitudinal axis of the outer tube.

In embodiments, each of the pair of transverse channels may define asecond portion adjacent to the first portion that extends in a parallelorientation relative to the longitudinal axis of the outer tube.

In embodiments, each of the pair of transverse channels may define athird portion adjacent to the second portion that defines an obliqueangle with respect to the longitudinal axis of the outer tube.

The pusher bar may include a transverse pin disposed on a proximalportion thereof that is configured to slidably engage the pair oftransverse channels.

In embodiments, a proximal portion of the pusher bar may define an armforming an oblique angle with respect to a second longitudinal axisdefined by the pusher bar.

The reposable surgical clip applier may further include a biasingelement. A first end of the biasing element is coupled to the pusher barand a second end of the biasing element is coupled to the outer tubesuch that the biasing element biases the pusher bar in a proximaldirection.

In embodiments, when the pusher bar is in a distal-most position, thefin may disengage from the leg of the pusher bar to permit the spindleto advance in a distal direction separate from the pusher bar.

BRIEF DESCRIPTION OF THE DRAWINGS

A particular embodiment of a surgical clip applier is disclosed hereinwith reference to the drawings wherein:

FIG. 1 is a perspective view of a reposable endoscopic surgical clipapplier, according to the present disclosure including a reusable handleassembly, and a first endoscopic assembly and a second endoscopicassembly each selectively connectable to the handle assembly;

FIG. 2 is perspective view of the reposable endoscopic surgical clipapplier including the reusable handle assembly and the first endoscopicassembly connected thereto;

FIG. 3 is a perspective view of the handle assembly with at least ahousing half-section removed therefrom;

FIG. 4 is a perspective view, with parts separated, of the handleassembly of FIGS. 1-3;

FIG. 5 is an enlarged perspective view of the indicated area of detailof FIG. 4, illustrating a pawl switch and a pawl actuator of the handleassembly of FIG. 1;

FIG. 6 is a further perspective view of the pawl switch of FIG. 5;

FIG. 7 is a further perspective view of the pawl actuator of FIG. 5;

FIGS. 8-9 are various perspective views of the pawl switch and the pawlactuator of the handle assembly, shown in operation with the pawl switchin an un-actuated condition and the pawl actuator engaged with a pawl ofa ratchet assembly;

FIG. 10 is a top plan view of the pawl switch and the pawl actuator ofthe handle assembly, shown in operation with the pawl switch in theun-actuated condition and the pawl actuator engaged from the pawl of theratchet assembly;

FIG. 11 is a transverse, cross-sectional view of the handle assembly ofFIG. 1 as taken through 11-11 of FIG. 1, illustrating the pawl switch inan actuated condition;

FIGS. 12-13 are various perspective views of the pawl switch and thepawl actuator of the handle assembly, shown in operation with the pawlswitch in the actuated condition and the pawl actuator disengaged fromthe pawl of the ratchet assembly;

FIG. 14 is a top plan view of the pawl switch and the pawl actuator ofthe handle assembly, shown in operation with the pawl switch in theactuated condition and the pawl actuator disengaged from the pawl of theratchet assembly;

FIG. 15 is a perspective view, with parts separated, of the firstendoscopic assembly of FIG. 1;

FIG. 16 is a top, plan view of the first endoscopic assembly of FIGS. 1and 15;

FIG. 17 is a transverse, cross-sectional view of the first endoscopicassembly of FIGS. 1 and 15-16, as taken through 17-17 of FIG. 16;

FIG. 18 is a perspective view illustrating an initial connection of thehandle assembly and the first endoscopic assembly;

FIG. 19 is a longitudinal, transverse cross-sectional view illustratingthe initial connection of the handle assembly and the first endoscopicassembly;

FIG. 20 is an enlarged view of the indicated area of detail of FIG. 19;

FIG. 21 is a longitudinal, transverse cross-sectional view illustratinga complete connection of the handle assembly and the first endoscopicassembly;

FIG. 22 is an enlarged view of the indicated area of detail of FIG. 21;

FIG. 23 is a longitudinal, transverse cross-sectional view illustratingan initial actuation of the handle assembly with the first endoscopicassembly connected thereto;

FIG. 24 is an enlarged view of the indicated area of detail of FIG. 23;

FIG. 25 is a longitudinal, transverse cross-sectional view illustratinga complete actuation of the handle assembly with the first endoscopicassembly connected thereto;

FIG. 26 is perspective view of the reposable endoscopic surgical clipapplier including the reusable handle assembly and the second endoscopicassembly connected thereto;

FIG. 27 is a perspective view, with parts separated, of the secondendoscopic assembly of FIGS. 1 and 26;

FIG. 28 is a perspective view, with parts separated, of a shaft assemblyof the second endoscopic assembly;

FIG. 29 is a perspective view of the distal end of the shaft assembly ofthe second endoscopic assembly with an outer tube removed therefrom;

FIG. 30 is an enlarged view of the indicated area of detail of FIG. 29;

FIG. 31 is an enlarged view of the indicated area of detail of FIG. 29;

FIG. 32 is a perspective view of the distal end of the shaft assembly ofthe second endoscopic assembly with the outer tube and a pusher barremoved therefrom;

FIG. 33 is an enlarged view of the indicated area of detail of FIG. 32;

FIG. 34 is an enlarged view of the indicated area of detail of FIG. 32;

FIG. 35 is a perspective view of the distal end of the shaft assembly ofthe second endoscopic assembly with the outer tube, the pusher bar and aclip channel removed therefrom;

FIG. 36 is an enlarged view of the indicated area of detail of FIG. 35;

FIG. 37 is an enlarged view of the indicated area of detail of FIG. 35;

FIG. 38 is a perspective view of the distal end of the shaft assembly ofthe second endoscopic assembly with the outer tube, the pusher bar, theclip channel and a pair of jaws and a filler component removedtherefrom;

FIG. 39 is a perspective view of the distal end of the shaft assembly ofthe second endoscopic assembly with the outer tube, the pusher bar, theclip channel, the pair of jaws, the filler component, and a wedge plateremoved therefrom;

FIG. 40 is a longitudinal, transverse cross-sectional view illustratinga complete connection of the handle assembly and the second endoscopicassembly, prior to actuation of a trigger of the handle assembly;

FIG. 41 is a longitudinal, transverse cross-sectional view illustratinga complete actuation of the handle assembly with the second endoscopicassembly connected thereto;

FIG. 42 is a side view of a portion of an alternate embodiment of anendoscopic assembly in accordance with the present disclosure;

FIG. 43 is an enlarged view of the area of detail indicated in FIG. 42;

FIG. 43A is a plan view of a pusher bar of the endoscopic assembly ofFIG. 42;

FIG. 44 is a side view of the endoscopic assembly of FIG. 42;

FIG. 45 is another side view of the endoscopic assembly of FIG. 42,shown with a pusher bar of the endoscopic assembly of FIG. 42 in adistal position;

FIG. 46 is yet another side view of the endoscopic assembly of FIG. 42,shown with the pusher bar returned to an initial, unactuated position:

FIG. 47 is still another side view of the endoscopic assembly of FIG.42, shown with a spindle of the endoscopic assembly of FIG. 42 returningto an initial, unactuated position;

FIG. 48 is another side view of the endoscopic assembly of FIG. 42,showing the spindle continuing to return to the initial, unactuatedposition;

FIG. 49 is yet another side view of the endoscopic assembly of FIG. 42,shown with the spindle and pusher bar returned to the initial,unactuated position;

FIG. 50 is a perspective view of a spindle and slider joint of theendoscopic assembly of FIG. 42; and

FIG. 51 is a schematic illustration of a robotic surgical systemconfigured for use in accordance with the present disclosure.

DETAILED DESCRIPTION OF EMBODIMENTS

Embodiments of reposable endoscopic surgical clip appliers, inaccordance with the present disclosure, will now be described in detailwith reference to the drawing figures wherein like reference numeralsidentify similar or identical structural elements. As shown in thedrawings and described throughout the following description, as istraditional when referring to relative positioning on a surgicalinstrument, the term “proximal” refers to the end of the apparatus whichis closer to the user and the term “distal” refers to the end of theapparatus which is further away from the user.

Referring now to FIGS. 1-29, an endoscopic surgical clip applier inaccordance with an embodiment of the present disclosure, and assembly ina particular configuration, is generally designated as 10. Surgical clipapplier 10 generally includes a reusable handle assembly or actuationassembly 100, at least one disposable or reusable endoscopic assembly200 selectively connectable to and extendable distally from handleassembly 100; and optionally at least one disposable surgical clipcartridge assembly (not shown) selectively loadable into a shaftassembly of a respective endoscopic assembly 200.

Briefly, the shaft assembly of endoscopic assembly 200 may have variousouter diameters such as, for example, about 5 mm or about 10 mm,depending on intended use. Further, the shaft assembly may have variousrelatively elongated or shortened lengths depending on intended use,such as, for example, in bariatric surgery. In one embodiment, inbariatric surgery, the shaft assembly may have a length of between about30 cm and about 40 cm. Further, the shaft assembly may be configured tofire and form a specific type of surgical clip, either individually ormultiply. However one skilled in the art should appreciate that theshaft assembly may have any length in excess of about 30 cm and thepresent disclosure is not limited to any of the above identifiedlengths.

In accordance with the present disclosure, as will be discussed ingreater detail below, an endoscopic assembly or a surgical clipcartridge assembly (not shown) may be loaded with a particularly sizedset of surgical clips (e.g., relatively small surgical clips, relativelymedium surgical clips, or relatively large surgical clips). It iscontemplated that clip cartridge assemblies may be configured to beselectively loaded into the shaft assembly of a respective endoscopicassembly 200, and to be actuated by the same or common handle assembly100, to fire and form the surgical clip(s) loaded therein ontounderlying tissue and/or vessels.

Referring now to FIGS. 1-14, handle assembly 100 of surgical clipapplier 10 is shown and will be described. Handle assembly 100 includesa housing 102 having a first or right side half-section 102 a and asecond or left side half-section 102 b. Housing 102 of handle assembly100 further includes or defines, as seen in FIGS. 3 and 4, a nose 102 c.Housing 102 of handle assembly 100 may be formed of a suitable plasticor thermoplastic material. It is further contemplated that housing 102of handle assembly 100 may be fabricated from stainless steel of thelike.

Handle assembly 100 includes a trigger 104 pivotably supported betweenright side half-section 102 a and left side half-section 102 b ofhousing 102. Trigger 104 is biased by a biasing member 104 a (e.g., areturn spring, compression spring or torsion spring) to an unactuatedcondition. Specifically, biasing member 104 a (FIG. 4) acts on a featureof trigger 104 and on a feature of housing 102 to bias or urge trigger104 to the un-actuated condition. Trigger 104 includes a drive arm 104 bextending therefrom. Drive arm 104 b may be integrally formed therewithor may be separately and fixedly secured to trigger 104. Drive arm 104 bmay define a curved, radiused or filleted upper distal surface.

As illustrated in FIGS. 3, 4 and 8-14, trigger 104 supports or isprovided with at least one linear rack 152 of teeth 152 a of a ratchetassembly 150, as will be described in detail below.

With reference to FIGS. 3, 4, 11, handle assembly 100 includes a driveplunger 120 operatively connected to trigger 104. Specifically, driveplunger 120 is slidably supported within housing 102 and defines a pairof opposed, axially extending slots 120 a formed in an outer surfacethereof. Slots 120 a of drive plunger 120 are configured to slidablyengage or receive opposed tabs 102 d of housing 102. Drive plunger 120further defines a proximally extending trigger slot 120 b formed in aproximal portion thereof for operatively receiving drive arm 104 b oftrigger 104. Trigger slot 120 b defines a distal surface or wall 120 cagainst which a distal surface of drive arm 104 b of trigger 104contacts in order to distally advance drive plunger 120 during anactuation of trigger 104.

Drive plunger 120 further includes a tooth 120 d (FIG. 11) projectinginto trigger slot 120 b. Tooth 120 d projects substantially towardtrigger 104 and includes a distal surface or wall 120 d 1 (spacedproximally from distal surface or wall 120 c of drive plunder 120), anda proximal, angled wall 120 d 2 tapering to a relatively smaller heightin a proximal direction.

Drive plunger 120 additionally includes a tab or fin 120 e projectingfrom a surface thereof. Tab 120 e of drive plunger 120 may besubstantially aligned or in registration with tooth 120 d of driveplunger 120. Tab 120 e of drive plunger 120 may project in a directionsubstantially opposite to tooth 120 d of drive plunger 120 or to trigger104.

With reference to FIGS. 1-4 and 11, handle assembly 100 includes anendoscopic assembly release lever 130 pivotally supported on andconnected to housing 102 via a pivot pin 132. Pivot pin 132 is supportedin housing 102. Release lever 130 includes a proximal end 130 aextending proximally of pivot pin 132. Proximal end 130 a of releaselever 130 includes a wall 130 c dimensioned to extend toward a pawlswitch 140 of handle assembly 100, as will be described in greaterdetail below.

Release lever 130 includes a distal end 130 b extending distally ofpivot pin 132. Distal end 130 b of release lever 130 includes a catch ortooth 130 d projecting therefrom, in a direction towards drive plunger120. Catch 130 d may be located distal of drive plunger 120.

A biasing member 134, in the form of a leaf spring, may be providedwhich tends to bias distal end 130 b and catch 130 d of release lever130 towards drive plunger 120 of handle assembly 100, and tends to biasproximal end 130 a of release lever 130 away from pawl switch 140.Specifically, biasing member 134 tends to maintain catch 130 d ofrelease lever 130 in engagement with an engagement feature (e.g.,annular channel 212 c) of endoscopic assembly 200, as will be describedin greater detail below.

With reference to FIGS. 3, 4 and 11-14, as mentioned above, handleassembly 100 includes a ratchet assembly 150 supported within housing102. Ratchet assembly 150 includes, as also mentioned above, at leastone linear rack 152 of teeth 152 a supported on and projecting fromtrigger 104. Ratchet assembly 150 further includes a ratchet pawl 154pivotally connected to housing 102 by a pawl pin at a location whereinpawl 154 is in substantial operative engagement with rack 152. Ratchetassembly 150 further includes a pawl spring 156 configured andpositioned to bias pawl 154 into operative engagement with rack 152.Pawl spring 156 functions to maintain the tooth or teeth 154 a of pawl154 in engagement with teeth 152 a of rack 152, as well as to maintainpawl 154 in a rotated or canted position.

Pawl 154 is engagable with rack 152 to restrict longitudinal movement ofrack 152 and, in turn, trigger 104. In use, as trigger 104 is actuated(from a fully un-actuated position), rack 152 is also moved, intoengagement with pawl 154. Rack 152 has a length which allows pawl 154 toreverse and advance back over rack 152, when rack 152 changes betweenproximal or distal movement, as trigger 104 reaches a fully actuated orfully un-actuated position. The relative lengths and sizes of rack 152of ratchet assembly 150, trigger 104 and drive plunger 120 define astroke length of trigger 104, drive plunger 120 or handle assembly 100(e.g., a “full stroke”).

Turning now to FIGS. 1, 2, 4, 11 and 18, handle assembly 100 includes arotation knob 160 rotatably supported on nose 102 c of housing 102.Rotation knob 160 includes a central axial bore 160 a having an annulararray of longitudinally extending grooves 160 b (FIG. 18) formed in asurface thereof. Grooves 160 b of rotation knob 160 function as clockingand alignment features for the connection of endoscopic assembly 200with handle assembly 100. Rotation knob 160 further includes a pluralityof finger grip ribs 160 c projecting from an outer surface thereof.

With reference to FIGS. 3 and 4-14, handle assembly 100 further includesa pawl switch 140 and a pawl actuator 142 each pivotally supported inhousing 102. Pawl switch 140 is operatively connected to pawl actuator142 and is operable to selectively move pawl actuator 142 into or out ofengagement with pawl spring 156, and in turn pawl 154, of ratchetassembly 150 whereby pawl 154 may be selectively engaged by pawl spring156. In this manner, when pawl 154 is moved out of engagement with pawlspring 156, trigger 104 is free to open and close as needed due to pawl154 having minimal blocking effect on rack 152 of ratchet assembly 150.As such, trigger 104 may be partially actuated (without having to befully actuated), and may be returnable to a fully un-actuated position.Such a feature permits the user to partially squeeze or actuate trigger104 for performing a cholangiogram procedure or the like.

Pawl switch 140 includes a finger lever 140 a projecting from housing102, whereby pawl switch 140 may be actuated by a finger of a user.Housing 102 of handle assembly 100 may be provided with guard walls 102d disposed on opposed sides of finger lever 140 a in order to inhibitinadvertent actuation of pawl switch 140. Pawl switch 140 is movable,upon actuation of finger lever 140 a, between a first position in whichratchet assembly 150 is “on” or “activated”, and a second position inwhich ratchet assembly 150 is “off” or “de-activated.” It iscontemplated that pawl switch 140, and in turn ratchet assembly 150,default to the first position.

Pawl switch 140 further includes a first flange 140 b projecting a firstdistance from a pivot point thereof, and a second flange 140 cprojecting a second distance from the pivot point thereof, wherein theprojection of the second flange 140 c is greater than the projection ofthe first flange 140 b. First flange 140 b of pawl switch 140 isselectively engagable by wall 130 c of proximal end 130 a of releaselever 130. In this manner, each time an endoscopic assembly 200 isattached to handle assembly 100, and release lever 130 is actuated, wall130 c of release lever 130 engages first flange 140 b of pawl switch 140to move pawl switch to the first position (FIGS. 19-22).

Pawl switch 140 also includes a ramp or camming surface 140 d projectingtherefrom which selectively engages a tab or finger 142 a of pawlactuator 142 to slidably move pawl actuator 142, and in turn pawl spring156, into and out of operative engagement/registration with/from pawl154.

Pawl actuator 142 is pivotally connected to housing 102 and operativelyconnected to pawl switch 140 such that actuation of pawl switch 140actuates pawl actuator 142. Pawl actuator 142 is slidably supported on apair of support pins 143 a, 143 b, and a biasing member 144 is providedto bias pawl actuator 142 against pawl switch 140. In operation, withreference to FIGS. 11-14, when pawl switch 140 is actuated to the secondposition, ramp or camming surface 140 d of pawl switch 140 acts on tab142 a of pawl actuator 142 to transversely slide pawl actuator 142 alongsupport pins 143 a, 143 b and move pawl spring 156 out of operativeengagement/registration with pawl 154, thereby disabling the operabilityof ratchet assembly 150. Also, as pawl actuator 142 is slid transverselyalong support pins 143 a, 143 b, pawl actuator 142 biases biasing member144.

Further in operation, with reference to FIGS. 8-10, when pawl switch 140is actuated to the first position, ramp or camming surface 140 d of pawlswitch 140 is moved to permit biasing member 144 to expand andtransversely slide pawl actuator 142 along support pins 143 a, 143 b,whereby pawl spring 156 is moved back into operativeengagement/registration with pawl 154, thereby enabling or re-enablingthe operability of ratchet assembly 150.

Turning now to FIGS. 1, 2, 16 and 17, an embodiment of an endoscopicassembly 200, of surgical clip applier 10, is shown and described.Endoscopic assembly 200 includes a hub assembly 210, a shaft assembly220 extending from hub assembly 210, and a pair of jaws 250 pivotallyconnected to a distal end of shaft assembly 220. It is contemplated thatendoscopic assembly 200 may be configured to close, fire or formsurgical clips similar to those shown and described in U.S. Pat. No.4,834,096, the entire content of which is incorporated herein byreference.

Hub assembly 210 functions as an adapter assembly which is configuredfor selective connection to rotation knob 160 and nose 102 c of housing102 of handle assembly 100. Hub assembly 210 includes an outer housing212 having a cylindrical outer profile. Outer housing 212 includes afirst or right side half section 212 a, and a second or left side halfsection 212 b. Outer housing 212 of hub assembly 210 defines an outerannular channel 212 c formed in an outer surface thereof, and at leastone (or an annular array) of axially extending ribs 212 d projectingfrom an outer surface thereof. Outer annular channel 212 c of outerhousing 212 of endoscopic assembly 200 is configured to receive catch130 d of release lever 130 of handle assembly 100 (FIGS. 19-22) whenendoscopic assembly 200 is coupled to handle assembly 100.

Ribs 212 d of outer housing 212 function as a clocking/alignment featureduring connection of endoscopic assembly 200 and handle assembly 100with one another, wherein ribs 212 d of outer housing 212 of endoscopicassembly 200 are radially and axially aligned with respective grooves160 b of rotation knob 160 of handle assembly 100. During connection ofendoscopic assembly 200 and handle assembly 100, ribs 212 d of outerhousing 212 of endoscopic assembly 200 are slidably received inrespective grooves 160 b of rotation knob 160 of handle assembly 100.

The connection of hub assembly 210 of endoscopic assembly 200 withrotation knob 160 of handle assembly 100 enables endoscopic assembly 200to rotate 360°, about a longitudinal axis thereof, relative to handleassembly 100.

Outer housing 212 of hub assembly 210 further defines an open proximalend 212 e configured to slidably receive a distal end of drive plunger120 of handle assembly 100, when endoscopic assembly 200 is coupled tohandle assembly 100 and/or when surgical clip applier 10 is fired.

As mentioned above, endoscopic assembly 200 includes a shaft assembly220 extending distally from hub assembly 210. Shaft assembly 220includes an elongate outer tube 222 having a proximal end 222 asupported and secured to outer housing 212 of hub assembly 210, a distalend 222 b projecting from outer housing 212 of hub assembly 210, and alumen 222 c (FIGS. 15 and 17) extending longitudinally therethrough.Distal end 222 b of outer tube 222 supports or defines an outer clevis222 d for pivotally supporting a pair of jaws 250, as will be describedin greater detail below.

Shaft assembly 220 further includes an inner shaft 224 slidablysupported within lumen 222 c of outer tube 222. Inner shaft 224 includesa proximal end 224 a projecting proximally from proximal end 222 a ofouter tube 222, and a distal end 224 b defining an inner clevis 224 cfor supporting a cam pin 224 d which engages camming slots 252 c, 254 cof a pair of jaws 250, as will be described in greater detail below.

With reference to FIGS. 15 and 17, hub assembly 210 includes a driveassembly 230 supported within outer housing 212 thereof. Drive assembly230 includes a cartridge cylinder 232 having a cup-like configuration,wherein cartridge cylinder 232 includes an annular wall 232 a, aproximal wall 232 b supported at and closing off a proximal end ofannular wall 232 a, an open distal end 232 c, and a cavity or bore 232 ddefined therewithin.

Drive assembly 230 also includes a cartridge plunger 234 slidablysupported within bore 232 d of cartridge cylinder 232. Cartridge plunger234 is fixedly supported on inner shaft 224, at the proximal end 224 athereof. Cartridge plunger 234 is sized and configured for slidablereceipt within bore 232 d of cartridge cylinder 232 of drive assembly230. A ring, flange or the like 235 may be fixedly supported at a distalend of bore 232 d of cartridge cylinder 232, through which proximal end224 a of cartridge plunger 234 extends and which functions to maintaincartridge plunger 234 within bore 232 d of cartridge cylinder 232.

Drive assembly 230 includes a first biasing member 236 (e.g., acompression spring) disposed within bore 232 d of cartridge cylinder232. Specifically, first biasing member 236 is interposed betweenproximal wall 232 b of cartridge cylinder 232 and a proximal surface ofcartridge plunger 234. First biasing member 236 has a first springconstant “K1” which is relatively more firm or more stiff, as comparedto a second spring constant “K2” of a second biasing member 238, as isdescribed in detail below.

Drive assembly 230 further includes a second biasing member 238 (e.g., acompression spring) supported on proximal end 224 a of inner shaft 224.Specifically, second biasing member 238 is interposed between a proximalflange 222 d of outer tube 222 and a distal surface of cartridge plunger234. Second biasing member 238 has a second spring constant “K2” whichis relatively less firm or less stiff, as compared to the first springconstant “K1” of first biasing member 236.

As illustrated in FIGS. 15 and 17, endoscopic assembly 200 includes apair of jaws 250 pivotally supported in a clevis 222 d at distal end 222b of outer tube 222 by a pivot pin 256. The pair of jaws 250 includes afirst jaw 252 and a second jaw 254. Each jaw 252, 254 includes arespective proximal end 252 a, 254 a, and a respective distal end 252 b,254 b, wherein proximal ends 252 a, 254 a and distal ends 252 b, 254 bof jaws 252, 254 are pivotable about pivot pin 256. Each proximal end252 a, 254 a of respective jaws 252, 254 defines a cam slot 252 c, 254 ctherein which is sized and configured to receive cam pin 224 d of innershaft 224. In use, as inner shaft 224 is axially displaced relative toouter shaft 222, inner shaft 224 translated cam pin 224 d thereofthrough cam slot 252 c, 254 c of jaws 252, 254 to thereby open or closethe pair of jaws 250.

When the pair of jaws 250 are in an open position, and a new, unformedor open surgical clip (not shown) is located or loaded within the distalends 252 b, 254 b of jaws 252, 254 of the pair of jaws 250, as innershaft 224 is moved distally relative to outer shaft 222, cam pin 224 dis translated through cam slots 252 c, 254 c of jaws 252, 254. As campin 224 d is translated through cam slots 252 c, 254 c of jaws 252, 254the distal ends 252 b, 254 b of jaws 252, 254 are moved to the closed orapproximated position to close and/or form the surgical clip located orloaded therewithin.

The dimensions of jaws 252, 254 and of cam slots 252 c, 254 c of jaws252, 254 determines an overall length required to move jaws 252, 254from a fully open position to a fully closed position, defining aclosure stroke length of the pair of jaws 250.

With reference now to FIGS. 19-25, an operation or firing of surgicalclip applier 10, including endoscopic assembly 200 operatively connectedto handle assembly 100, is shown and described. With endoscopic assembly200 operatively connected to handle assembly 100, and with a new,unformed or open surgical clip (not shown) is located or loaded withinthe distal ends 252 b, 254 b of jaws 252, 254 of the pair of jaws 250,as trigger 104 of handle assembly 100 is actuated drive bar 104 b oftrigger 104 acts on drive plunger 120 to distally advance drive plunger120. As trigger 104 is actuated, pawl 154 of ratchet assembly 150 beginsto engage rack 152 thereof. With pawl 154 engaged with rack 152, trigger104 may not return to a fully unactuated position until trigger 104completes a full actuation or stroke thereof.

As drive plunger 120 is distally advanced, a distal end of drive plunger120 presses against proximal wall 232 b of cartridge cylinder 232 ofdrive assembly 230 of endoscopic assembly 200 to distally advancecartridge cylinder 232. Due to first spring constant “K1” of firstbiasing member 236 being larger or greater than second spring constant“K2” of second biasing member 238, as cartridge cylinder 232 is advanceddistally, cartridge cylinder 232 distally advances first biasing member236, which in turn acts on cartridge plunger 234 to distally advancecartridge plunger 234. As cartridge plunger 234 is distally advanced,cartridge plunger 234 distally advances inner shaft 224 relative toouter shaft 222. Being that second biasing member 238 is interposedbetween proximal flange 222 d of outer tube 222 and distal surface ofcartridge plunger 234, as cartridge plunger 234 is distally advanced,cartridge plunger 234 also compresses second biasing member 238.

As inner shaft 224 is distally advanced relative to outer shaft 222,inner shaft 224 distally advances cam pin 224 d through cam slot 252 c,254 c of jaws 252, 254 to close the pair of jaws 250 and to close and/orform the surgical clip (not shown) loaded within the pair of jaws 250.Cam pin 224 d of inner shaft 224 is advanced distally until cam pin 224d reaches an end of cam slots 252 c, 254 c of jaws 252, 254 of the pairof jaws 250 and/or until the distal ends 252 b, 254 b of jaws 252, 254of the pair of jaws 250 are fully approximated against one another(e.g., in contact with one another or fully closed on the surgical clip(not shown)), whereby cam pin 224 d may not have reached the end of camslots 252 c, 254 c of jaws 252, 254. This position may be considered ahard stop of the pair of jaws 250. The axial distance that cam pin 224 dhas traveled from a proximal-most position thereof to when cam pin 224 dreaches the end of cam slots 252 c, 254 c of jaws 252, 254 or when thedistal ends 252 b, 254 b of jaws 252, 254 of the pair of jaws 250 arefully approximated against one another, may also define the closurestroke length of the pair of jaw 250.

When the pair of jaws 250 have reached the hard stop, or when the campin 224 d has reached an end of the closure stroke length, pawl 154 ofratchet assembly 150 of handle assembly 100 may not have cleared rack152 thereof, and thus blocks or prevents trigger 104 from returning to afully unactuated position thereof. Since the pair of jaws 250 cannotclose any further, and since cam pin 224 d cannot be advanced distallyany further, inner shaft 222 is also stopped from further distaladvancement. However, as mentioned above, in order to return trigger 104to the fully unactuated position, trigger 104 must first complete thefull actuation stroke thereof. As such, as trigger 104 is furtheractuated to complete the full stroke thereof, as drive plunger 120 iscontinued to be driven distally, the distal end of drive plunger 120continues to press against proximal wall 232 b of cartridge cylinder 232of drive assembly 230 of endoscopic assembly 200 to continue to distallyadvance cartridge cylinder 232.

With inner shaft 222, and in turn cartridge plunger 234, stopped fromany further distal advancement, as cartridge cylinder 232 is continuedto be advanced distally, cartridge cylinder 232 begins to and continuesto compress first biasing member 236 until such time that pawl 154 ofratchet assembly 150 of handle assembly 100 clears and disengages rack152 thereof. With pawl 154 of ratchet assembly 150 clear and disengagedfrom rack 152, trigger 104 may be released and returned to the fullyunactuated position by hand, by a return spring 104 a of trigger 104and/or by first biasing member 236 and second biasing member 238 ofendoscopic assembly 200.

In accordance with the present disclosure, the trigger stroke length fortrigger 104 of handle assembly 100 is constant or fixed, while theclosure stroke length of the pair of jaws 250 may vary depending on theparticular endoscopic assembly 200 connected to handle assembly 100. Forexample, particular endoscopic assemblies 200 may require the pair ofjaws 250 thereof to travel a relatively greater or smaller distance inorder to complete a full opening and closing thereof. As such, varioussized and dimensioned endoscopic assemblies, including a hub assembly inaccordance with the present disclosure, substantially similar to hubassembly 210, may be connected to the universal handle assembly 100 andbe actuatable by the universal handle assembly 100.

Accordingly, various endoscopic assemblies, constructed in accordancewith the principles of the present disclosure, may be provided which arealso capable of firing or forming or closing surgical clips of varioussizes, materials, and configurations, across multiple platforms formultiple different manufactures.

Turning now to FIGS. 26-29, an endoscopic surgical clip applier, inaccordance with the present disclosure, and assembly in anotherconfiguration, is generally designated as 10′. Surgical clip applier 10′generally includes reusable handle assembly 100, at least one disposableor reusable endoscopic assembly 400 selectively connectable to andextendable distally from handle assembly 100; and optionally at leastone disposable surgical clip cartridge assembly (not shown) selectivelyloadable into a shaft assembly of a respective endoscopic assembly 400.

Turning now to FIGS. 1, 2, 16 and 17, an embodiment of an endoscopicassembly 400, of surgical clip applier 10′, is shown and described.Endoscopic assembly 400 includes a hub assembly 410, a shaft assembly420 extending from hub assembly 410, and a pair of jaws 450 pivotallyconnected to a distal end of shaft assembly 420. It is contemplated thatendoscopic assembly 400 may be configured to close, fire or formsurgical clips similar to those shown and described in U.S. Pat. No.7,819,886 or 7,905,890, the entire contents of each of which isincorporated herein by reference.

Hub assembly 410 also functions as an adapter assembly which isconfigured for selective connection to rotation knob 160 and nose 102 cof housing 102 of handle assembly 100. Hub assembly 410 includes anouter housing 412 having a cylindrical outer profile. Outer housing 412includes a first or right side half section 412 a, and a second or leftside half section 412 b. Outer housing 412 of hub assembly 410 definesan outer annular channel 412 c formed in an outer surface thereof, andat least one (or an annular array) of axially extending ribs 412 dprojecting from an outer surface thereof. Outer annular channel 412 c ofouter housing 412 of endoscopic assembly 400 is configured to receivecatch 130 d of release lever 130 of handle assembly 100 (FIGS. 28 and29) when endoscopic assembly 400 is coupled to handle assembly 100.

Ribs 412 d of outer housing 412 function as a clocking/alignment featureduring connection of endoscopic assembly 400 and handle assembly 100with one another, wherein ribs 412 d of outer housing 412 of endoscopicassembly 400 are radially and axially aligned with respective grooves160 b of rotation knob 160 (FIG. 18) of handle assembly 100. Duringconnection of endoscopic assembly 400 and handle assembly 100, ribs 412d of outer housing 412 of endoscopic assembly 400 are slidably receivedin respective grooves 160 b of rotation knob 160 of handle assembly 100.

The connection of hub assembly 410 of endoscopic assembly 400 withrotation knob 160 of handle assembly 100 enables endoscopic assembly 400to rotate 360°, about a longitudinal axis thereof, relative to handleassembly 100.

Outer housing 412 of hub assembly 410 further defines an open proximalend 412 e configured to slidably receive a distal end of drive plunger120 of handle assembly 100, when endoscopic assembly 400 is coupled tohandle assembly 100 and/or when surgical clip applier 10′ is fired.

As mentioned above, endoscopic assembly 400 includes a shaft assembly420 extending distally from hub assembly 410. Shaft assembly 420includes an elongate outer tube 422 having a proximal end 422 asupported and secured to outer housing 412 of hub assembly 410, a distalend 422 b projecting from outer housing 412 of hub assembly 410, and alumen 422 c (FIG. 27) extending longitudinally therethrough. Distal end422 b of outer tube 422 supports a pair of jaws 450.

Shaft assembly 420 further includes an inner shaft 424 slidablysupported within lumen 422 c of outer tube 422. Inner shaft 424 includesa proximal end 424 a projecting proximally from proximal end 422 a ofouter tube 422, and a distal end 424 b configured to actuate the pair ofjaws 450 to form a surgical clip (not shown) that has been loaded intothe pair of jaws 450. Proximal end 424 a, as illustrated in FIGS. 28 and29, may define a hook 424 c or other translational force couplingfeature.

With reference to FIGS. 27-29, hub assembly 410 includes a driveassembly 430 supported within outer housing 412 thereof. Drive assembly430 includes a cartridge cylinder 432 having a cup-like configuration,wherein cartridge cylinder 432 includes a longitudinally split annularwall 432 a, a proximal wall 432 b supported at and closing off aproximal end of annular wall 432 a, an open distal end 432 c, a cavityor bore 432 d defined therewithin, and a pair of axially extending slits432 e. Cartridge cylinder 432 includes an annular flange 432 f providedat distal end 432 c thereof. A ring, flange or the like 435 may befixedly supported at a proximal end of cartridge cylinder 432.

Drive assembly 430 also includes a cartridge plunger or key 434 slidablysupported within bore 432 d and within slits 432 e of cartridge cylinder432. Cartridge plunger 434 is selectively connectable to proximal end424 a of inner shaft 424. Cartridge plunger 434 is sized and configuredfor slidable receipt within slits 432 e and bore 432 d of cartridgecylinder 432 of drive assembly 430. Cartridge plunger 434 includes anelongate stem or body portion 434 a having a proximal end 434 b, and adistal end 434 c, wherein distal end 434 c of cartridge plunger 434 isconfigured for selective connection to proximal end 424 a of inner shaft424. Cartridge plunger 434 further includes a pair of opposed arms 434 dsupported at the proximal end 434 b thereof and which extend in a distaldirection along stem 434 a and towards distal end 434 c. Each arm 434 dterminates in a radially extending finger 434 e, wherein fingers 434 eproject from cartridge cylinder 432 when cartridge plunger 434 isdisposed within cartridge cylinder 432.

Drive assembly 430 may also include a collar 437 defining a lumentherethrough and through with inner shaft 424 and stem 434 a ofcartridge plunger 434 extend. Collar 437 includes an outer annularflange 437 a extending therefrom.

Drive assembly 430 includes a first biasing member 436 (e.g., acompression spring) disposed about cartridge cylinder 432. Specifically,first biasing member 436 is interposed between ring 435 supported oncartridge cylinder 432 and fingers 434 e of cartridge plunger 434. Firstbiasing member 436 has a first spring constant “K1” which is relativelymore firm or more stiff, as compared to a second spring constant “K2” ofa second biasing member 438, as is described in detail below.

Drive assembly 430 further includes a second biasing member 438 (e.g., acompression spring) supported on stem 434 a of cartridge plunger 434 andon collar 437. Specifically, second biasing member 438 is interposedbetween a flange 437 a of collar 437 and proximal end 434 b of cartridgeplunger 434. Second biasing member 438 has a second spring constant “K2”which is relatively less firm or less stiff, as compared to the firstspring constant “K1” of first biasing member 436.

Turning now to FIGS. 26-41, shaft assembly 420 of endoscopic assembly400 includes at least a spindle 440 slidably supported in lumen 422 c ofouter tube 422, a wedge plate 460 slidably supported within lumen 422 cof outer tube 422 and interposed between the pair of jaws 450 andspindle 440; a clip channel 470 fixedly supported in lumen 422 c ofouter tube 422 and disposed adjacent the pair of jaws 450 (supported inand extending from distal end 422 b of outer tube 422) on a sideopposite wedge plate 460, and a pusher bar 480 slidably supported inlumen 422 c of outer tube 422 and being disposed adjacent clip channel470.

Spindle 440 includes a proximal end 440 defining an engagement feature(e.g., a nub or enlarged head) configured to engage a complementaryengagement feature provided in distal end 424 b of inner shaft 424.Spindle 440 further includes a distal end 440 b operatively connected toa jaw cam closure wedge 442 via a slider joint 444. Jaw cam closurewedge 442 is selectively actuatable by spindle 440 to engage cammingfeatures of the pair of jaws 450 to close the pair of jaws 450 and forma surgical clip “C” loaded therewithin.

Slider joint 444 supports a latch member 446 for selective engagementwith spindle 440. Latch member 446 may be cammed in a direction towardspindle 440, wherein latch member 446 extends into a corresponding slotformed in spindle 440 during actuation or translation of spindle 440. Inoperation, during distal actuation spindle 400, at a predetermineddistance, latch member 446 is mechanically forced or cammed into andengage a channel of spindle 440. This engagement of latch member 446 inthe channel of spindle 440 allows slider joint 444 to move together withjaw cam closure wedge 442. Jaw cam closure wedge 442 thus can engage therelevant surfaces of the pair of jaws 450 to close the pair of jaws 450.

As illustrated in FIGS. 28 and 39, slider joint 444 is connected, at aproximal end 444 a thereof, to a channel formed in spindle 440. A distalend 444 b of slider joint 444 defines a substantially T-shaped profile,wherein the distal end 444 b thereof is connected to jaw cam closurewedge 442. Latch member 446 functions as a linkage and is disposed tomove through an aperture 444 c in slider joint 444 to link with anotherfixed member and prevent slider joint 444 from advancing jaw cam closurewedge 442, and thus preventing the camming of jaw cam closure wedge 442from camming the pair of jaws 450 to a closed condition during aninitial stroke of trigger 104.

Spindle 440 is provided with a camming feature configured to move a camlink 448 (pivotably connected to a filler component 466, as will bedescribed in greater detail below) a perpendicular manner relatively toa longitudinal axis of spindle 440 during a distal advancement ofspindle 440.

Clip channel 470 of shaft assembly 420 slidably retains a stack ofsurgical clips “C” therein for application, in seriatim, to the desiredtissue or vessel. A clip follower 472 is provided and slidably disposedwithin clip channel 470 at a location proximal of the stack of surgicalclips “C”. A biasing member 474 is provided to spring bias clip follower472, and in turn, the stack of surgical clips “C”, distally. A clipchannel cover 476 is provided that overlies clip channel 470 to retainand guide clip follower 472, biasing member 474 and the stack ofsurgical clips “C” in clip channel 470.

As mentioned above, shaft assembly 420 includes a pusher bar 480 forloading a distal-most surgical clip “C1” of the stack of surgical clips“C” into the pair of jaws 450. Pusher bar 480 includes a pusher 480 a ata distal end thereof for engaging a backspan of the distal-most surgicalclip “C1” and urging the distal-most surgical clip “C1” into the pair ofjaws 450. Pusher bar 480 includes a fin or tab 480 b extending therefromand extending into a slot 482 a of a trip block 482. Fin 480 b of pusherbar 480 is acted upon by a biasing member (not shown) that is supportedin trip block 482 to bias pusher bar 480 in a proximal direction.

In operation, in order for spindle 440 to advance pusher bar 480 duringa distal movement thereof, spindle 440 supports a trip lever 484 and abiasing member 486 (e.g., leaf spring). During a distal movement ofspindle 440, as illustrated in FIG. 31, a distal nose or tip 484 a oftrip lever 484 selectively engages pusher bar 480 to distally advancepusher bar 480 and load distal-most surgical clip “C1” into the pair ofjaws 450.

Also as mentioned above, shaft assembly 420 further includes a wedgeplate 460 that is biased to a proximal position by a wedge plate spring462. Wedge plate 460 is a flat bar shaped member having a number ofwindows formed therein. Wedge plate 460 has a distal-most positionwherein a tip or nose of wedge plate 460 is inserted between the pair ofjaws 450 to maintain the pair of jaws 450 in an open condition forloading of the distal-most surgical clip “C1” therein. Wedge plate 460has a proximal-most position, maintained by wedge plate spring 462,wherein the tip or nose of wedge plate 460 is retracted from between thepair of jaws 450.

As illustrated in FIGS. 28 and 38, wedge plate 460 defines a “U” or “C”shaped aperture or window 460 b in a side edge thereof. The “C” shapedaperture or window 460 b of wedge plate 460 selectively engages a camlink 448 supported on a filler plate 466. Cam link 448 selectivelyengages a surface of “C” shaped aperture or window 460 b of wedge plate460 to retain wedge plate 460 in a distal-most position such that adistal tip or nose 460 a of wedge plate 460 is maintained insertedbetween the pair of jaws 450 to maintain the pair of jaws 450 splayedapart.

Shaft assembly 420 further includes a filler component 466 interposedbetween clip channel 470 and wedge plate 460, at a location proximal ofthe pair of jaws 450. Filler component 466 pivotably supports a cam link448 that is engagable with wedge plate 460. In operation, during adistal advancement of spindle 440, a camming feature of spindle 440engages a cam link boss of cam link 448 to thereby move cam link 448 outof engagement of wedge plate 460 and permit wedge plate 460 to return tothe proximal-most position as a result of biasing member 462.

Trip block 482 defines an angled proximal surface 482 b for engagementwith a corresponding surface of trip lever 484 that will be discussedherein. As mentioned above, notch or slot 482 a of trip block 482 is forreceipt of fin 480 b of pusher bar 480. In order to disengage trip lever484 from a window 480 c (FIG. 31) of pusher bar 480, and allow pusherbar 480 to return to a proximal-most position following loading of asurgical clip “C” into the pair of jaws 450, angled proximal surface 482b trip block 482 engages trip lever 484 to cam trip lever 484 out ofwindow 480 c of pusher bar 480. It is contemplated that spindle 440 maydefine a first cavity and a second cavity therein for receiving triplever 484 and trip lever biasing spring 486, respectively. The firstcavity may be provided with a pivoting boss to allow trip lever 484 topivot between a first position and a second position. Trip lever biasingspring 486 may rest in the second cavity.

Trip lever biasing spring 486 functions to maintain a tip of trip lever484 in contact with pusher bar 480, and more specifically, within window480 c of pusher bar 480 (FIG. 31) such that distal advancement ofspindle 440 results in distal advancement of pusher bar 480, which inturn results in a loading of a distal-most surgical clip “C1” in thepair of jaws 450.

With reference to FIGS. 28, 33 and 36, clip applier 10′ also has alockout bar 490. Lockout bar 490 includes a first end, and a secondopposite hook end. The second hook end of lockout bar 490 is adapted toengage clip follower 472 of shaft assembly 420. Lockout bar 490 ispivotally retained in a slot formed in clip follower 472. Lockout bar490 does not by itself lockout clip applier 10′, but instead cooperateswith the ratchet mechanism 150 of handle assembly 100 to lock out clipapplier 10′.

Lockout bar 490 is adapted to move distally with clip follower 472 eachtime clip applier 10′ is fired, and clip follower 472 is advanceddistally. In operation, each time a surgical clip “C” is fired from clipapplier 10′, clip follower 472 will advance distally relative to theclip channel 470.

Pusher bar 480 defines a distal window therein (not shown). Inoperation, when clip follower 472 is positioned beneath pusher bar 480(e.g., when there are no remaining surgical clips), a distal end 490 aof lockout bar 490 will deflect upward (due to a biasing of a lockoutbiasing member 492), and enter a distal window 480 d of pusher bar 480to engage pusher bar 480 at a distal end of distal window 480 d.Further, a proximal end 490 b of lockout bar 490, defines a hook (FIG.37), which is rotated into and engages an aperture defined in a floor ofclip channel 470.

With the distal end of pusher bar 480 disposed within distal window 480d of pusher bar 480, pusher bar 480, and in turn, spindle 440 cannotreturn to a fully proximal position. Since spindle 440 cannot return tothe fully proximal position, pawl 152 of ratchet mechanism 150 of handleassembly 100 cannot return to the home or initial position relative torack 154 thereof. Instead, pawl 154 will remain in an intermediateposition along rack 154, thus preventing trigger 104 from returning to afully unactuated position.

With continued reference to FIGS. 26-29, an operation or firing ofsurgical clip applier 10′, including endoscopic assembly 400 operativelyconnected to handle assembly 100, is shown and described. Withendoscopic assembly 400 operatively connected to handle assembly 100, astrigger 104 of handle assembly 100 is actuated drive bar 104 b oftrigger 104 acts on drive plunger 120 to distally advance drive plunger120. As trigger 104 is actuated, pawl 154 of ratchet assembly 150 beginsto engage rack 152 thereof. With pawl 154 engaged with rack 152, trigger104 may not return to a fully unactuated position until trigger 104completes a full actuation or stroke thereof.

As drive plunger 120 is distally advanced, a distal end of drive plunger120 presses against proximal wall 432 b of cartridge cylinder 432 ofdrive assembly 430 of endoscopic assembly 400 to distally advancecartridge cylinder 432. Due to first spring constant “K1” of firstbiasing member 436 being larger or greater than second spring constant“K2” of second biasing member 438, as cartridge cylinder 432 is advanceddistally, ring 435 acts on first biasing member 436 which in turn actson fingers 434 e of cartridge plunger 434 to push cartridge plunger 434distally. As cartridge plunger 434 is distally advanced, cartridgeplunger 434 distally advances inner shaft 424 relative to outer shaft422. Being that second biasing member 438 is interposed between a flange437 a of collar 437 and proximal end 434 b of cartridge plunger 434, ascartridge plunger 434 is distally advanced, cartridge plunger 434 alsocompresses second biasing member 438.

As inner shaft 424 is distally advanced relative to outer shaft 422,inner shaft 424 actuates a clip pusher (not shown) which in turn acts ona distal-most surgical clip (not shown) of a stack of surgical clips(not shown) to distally advance the distal-most surgical clip into thepair of jaws 450. Following loading of the distal-most surgical clipinto the pair of jaws 450, the distal advancement of inner shaft 424effects a closure of the pair of jaws 450 to form the surgical cliploaded therewithin.

When the pair of jaws 450 have fully closed to form the surgical cliploaded therein, or when the pair of jaws 450 have reached a hard stop,pawl 154 of ratchet assembly 150 of handle assembly 100 may not havecleared rack 152 thereof, and thus blocks or prevents trigger 104 fromreturning to a fully unactuated position thereof. Since the pair of jaws450 cannot close any further, inner shaft 422 is also stopped fromfurther distal advancement. However, as mentioned above, in order toreturn trigger 104 to the fully unactuated position, trigger 104 mustfirst complete the full actuation stroke thereof. As such, as trigger104 is further actuated to complete the full stroke thereof, as driveplunger 120 is continued to be driven distally, the distal end of driveplunger 120 continues to press against proximal wall 432 b of cartridgecylinder 432 of drive assembly 430 of endoscopic assembly 400 tocontinue to distally advance cartridge cylinder 432.

With inner shaft 422, and in turn cartridge plunger 434, stopped fromany further distal advancement, as cartridge cylinder 432 is continuedto be advanced distally relative to cartridge plunger 434, cartridgecylinder 432 begins to and continues to compress first biasing member436 until such time that pawl 154 of ratchet assembly 150 of handleassembly 100 clears and disengages rack 152 thereof. With pawl 154 ofratchet assembly 150 clear and disengaged from rack 152, trigger 104 maybe released and returned to the fully unactuated position by hand, by areturn spring (not shown) of trigger 104 or handle assembly 100 and/orby first biasing member 436 and second biasing member 438 of endoscopicassembly 400.

In accordance with the present disclosure, the trigger stroke length fortrigger 104 of handle assembly 100 is constant or fixed, while theclosure stroke length of the pair of jaws 450 of endoscopic assembly 400connected to handle assembly 100 is different than, for example, theclosure stroke of the pair of jaws 250 of endoscopic assembly 200. Forexample, endoscopic assembly 400 may require the pair of jaws 450thereof to travel a relatively greater or smaller distance as comparedto the pair of jaws 250 of endoscopic assembly 200 in order to completea full opening and closing thereof. As such, universal handle assembly100 may be loaded with, and is capable of firing, either endoscopicassembly 200 or endoscopic assembly 400.

With reference to FIGS. 42-50, an alternate embodiment of the endoscopicassembly 400 is illustrated and generally identified by referencenumeral 500. The endoscopic assembly 500 is substantially similar tothat of the endoscopic assembly 400.

As best illustrated in FIG. 43, a pusher bar 580 of the endoscopicassembly 500 defines a top surface 580 a and a bottom surface 580 b. Aproximal portion of the pusher bar 580 defines a leg 582 that extends ina downward or transverse direction from the bottom surface 580 a anddefines a generally oblique angle with respect thereto. A proximalportion of the leg 582 defines a transverse bore (not shown) configuredto fixedly receive a transverse pin 590 using any suitable means, suchas interference fit, friction fit, adhesives, welding, or the like. Itis contemplated that a channel 584 (FIG. 43A) may be defined through theleg 582 such that the leg 582 defines a pair of arms 582 a, 582 b. Inthis manner, a central portion of the transverse pin 590 is exposed.

The elongate outer tube 522 of the shaft assembly 520 of the endoscopicassembly 500 defines a pair of transverse channels 524 configured toslidably receive a portion of the transverse pin 590 therein. Inembodiments, the pair of transverse channels 524 may be defined by aplurality of bosses (not shown) extending into a central portion of theouter tube 522. In this manner, the pair of transverse channels 524 doesnot extend through an outer surface 522 a of the outer tube 522. It isfurther contemplated that the pair of transverse channels 524 aredefined in an inner wall (not shown) of the outer tube 522, but do notextend through or beyond an outer surface 522 a of the outer tube 522.

As best illustrated in FIG. 44, the pair of transverse channels 524 ofthe elongate outer tube 522 defines a generally U-shaped configurationor profile. In this manner, each channel 524 includes a first orproximal portion 524 a having a generally vertical or orthogonalorientation with respect to the elongate outer tube 522. The firstportion 524 a of the transverse channels 524 transitions to a secondportion 524 b having a generally horizontal (e.g., parallel to an axisof the spindle 540) orientation that extends in a distal direction. Thesecond portion 524 b of the transverse channels 524 transitions to athird portion 524 c forming an oblique angle with respect to theelongate outer tube 522. In this manner, as the transverse pin 590 iscaused to be translated in a distal direction within the pair oftransverse channels 524, the transverse pin 590 cams along the shape ofthe pair of transverse channels 524. A stop pin 526 is fixedly retainedwithin a through-hole (not shown) defined through the outer tube 522.The stop pin 526 is disposed proximal of the pair of transverse channels524 and acts to inhibit further proximal translation of the spindle 540.

A spindle 540 of a drive assembly 530 is similar to the spindle 440described above with respect to the endoscopic assembly 400 above. Adistal portion of the spindle 540 includes a generally box shapedprofile (FIG. 50) defining a distal facing channel 542 configured toreceive a proximal portion of the slider joint 544. A pair of cams orfins 546 is disposed on a surface (e.g., upper surface) of the spindle540 and is configured to selectively engage a proximal portion of thepusher bar 580. Although illustrated as being an integral part of thespindle 540 (e.g., formed by bending the spindle 540), it iscontemplated that the pair of fins 546 may be separate parts that may beadhered to the spindle 540 using any suitable means, such as welding,adhesives, dovetail, friction fit, interference fit, or the like. Thepair of fins 546 includes a generally triangular shape forming a distalsurface 546 a (FIG. 48) that cants in a proximal direction, althoughother configurations are also contemplated, such as a generally verticalorientation. The distal surface 546 a of each fin 546 culminates at adistal peak 546 b and tapers in a proximal direction towards the uppersurface of the spindle 540 defining a tapered upper surface 546 c. Inthis manner, when the spindle 540 is urged in a distal direction, thedistal surface 546 a of the pair of fins 546 is configured to abut aproximal portion of the pusher bar 580 to urge the pusher bar 580 in adistal direction.

Endoscopic assembly 500 includes a biasing element 560 (FIG. 42) coupledto the pusher bar 580 on a first end and to the outer tube 522 on asecond end, and biases the pusher bar 580 in a proximal direction.Although generally illustrated as being a coil spring, it iscontemplated that the biasing element 560 may be any suitable biasingelement known in the art (e.g., elastomer, gas spring, or the like). Ascan be appreciated, the biasing element 560 may be a compression springsuch as a coil spring, leaf spring, Belleville washer, spring washer, orthe like.

With reference to FIGS. 42-50, in operation, the spindle 540 isinitially in a proximal, unactuated position (FIG. 43), and the pusherbar 580 is in a proximal-most position. During distal actuation of thespindle 540, the distal surface 546 a of the pair of fins 546 abuts aproximal portion of the leg 582 of the pusher bar 580 (FIG. 44).Concurrently, the slider joint 544 translates within the distal facingchannel 542 of the spindle 540. Continued distal advancement of thespindle 540 urges the pusher bar 580 in a distal direction, causing thetransverse pin 590 to translate within the pair of transverse channels524 of the outer tube 522. As the spindle 540 is further advanced, thepusher bar 580 loads a distal-most clip within a pair of jaws (notshown) that are pivotably disposed on a distal portion of the outer tube522. As the spindle 540 is further advanced in a distal direction, thetransverse pin 590 cams over the second portion 524 b and into the thirdportion 524 c (FIG. 45) of the pair of transverse channels 524.

As the pusher bar 580 is further advanced, the third portion 524 c ofthe pair of transverse channels 524 causes the leg 582 of the pusher bar580 to travel in a vertical or transverse direction with respect to thespindle 540, allowing the distal peak 546 b of the pair of fins 546 topass under the proximal portion of the leg 582, permitting the spindle540 to further advance in a distal direction without further distaladvancement of the pusher bar 580 (FIG. 46). At this point, the biasingelement 560 biases the pusher bar 580 to the initial, unactuatedposition. Continued distal advancement of the spindle 540 causes theslider joint 544 to translate along with the spindle 540 in a distaldirection to close the pair of jaws and form the surgical clip disposedwithin the pair of jaws.

Once the surgical clip has been formed, the spindle 540 is permitted toreturn to the proximal, unactuated, position. In this manner, as thespindle 540 translates in a proximal direction, the tapered surface 546c of the pair of fins 546 abuts the proximal portion of the leg 582 andcauses the transverse pin 590 to be cammed into the first portion 524 aof the pair of transverse channels 524 (FIG. 47) of the elongate outertube 522. In this manner, the pair of transverse channels 524 inhibitsthe transverse pin 590 from translating in a proximal direction andurges the leg 582 in a vertical or transverse direction to permit thedistal peak 546 b of the pair of fins 546 to pass under the proximalportion of the leg 582 to enable the spindle 540 to return to theinitial, unactuated position (FIG. 49).

In accordance with the present disclosure, while the trigger strokelength of trigger 104 of handle assembly 100 is constant, the closurestroke length for the pair of jaws 250, 450 of each endoscopic assembly200, 400, 500 is unique for each respective endoscopic assembly 200,400, 500. Accordingly, each drive assembly 230, 430, 530 of respectiveendoscopic assemblies 200, 400, 500 functions to accommodate for thevariations in the closure stroke lengths for the pair of jaws 250, 450of respective endoscopic assemblies 200, 400, 500.

To the extent consistent, handle assembly 100 and/or endoscopicassemblies 200, 400, 500 may include any or all of the features of thehandle assembly and/or endoscopic assemblies disclosed and described inInternational Patent Application No. PCT/CN2015/080845, filed Jun. 5,2015, entitled “Endoscopic Reposable Surgical Clip Applier,”International Patent Application No. PCT/CN2015/091603, filed on Oct.10, 2015, entitled “Endoscopic Surgical Clip Applier,” and/orInternational Patent Application No. PCT/CN2015/093626, filed on Nov. 3,2015, entitled “Endoscopic Surgical Clip Applier,” the entire content ofeach of which being incorporated herein by reference.

Surgical instruments such as the clip appliers described herein may alsobe configured to work with robotic surgical systems and what is commonlyreferred to as “Telesurgery.” Such systems employ various roboticelements to assist the surgeon and allow remote operation (or partialremote operation) of surgical instrumentation. Various robotic arms,gears, cams, pulleys, electric and mechanical motors, etc. may beemployed for this purpose and may be designed with a robotic surgicalsystem to assist the surgeon during the course of an operation ortreatment. Such robotic systems may include remotely steerable systems,automatically flexible surgical systems, remotely flexible surgicalsystems, remotely articulating surgical systems, wireless surgicalsystems, modular or selectively configurable remotely operated surgicalsystems, etc.

The robotic surgical systems may be employed with one or more consolesthat are next to the operating theater or located in a remote location.In this instance, one team of surgeons or nurses may prep the patientfor surgery and configure the robotic surgical system with one or moreof the instruments disclosed herein while another surgeon (or group ofsurgeons) remotely control the instruments via the robotic surgicalsystem. As can be appreciated, a highly skilled surgeon may performmultiple operations in multiple locations without leaving his/her remoteconsole which can be both economically advantageous and a benefit to thepatient or a series of patients.

The robotic arms of the surgical system are typically coupled to a pairof master handles by a controller. The handles can be moved by thesurgeon to produce a corresponding movement of the working ends of anytype of surgical instrument (e.g., end effectors, graspers, knifes,scissors, etc.) which may complement the use of one or more of theembodiments described herein. The movement of the master handles may bescaled so that the working ends have a corresponding movement that isdifferent, smaller or larger, than the movement performed by theoperating hands of the surgeon. The scale factor or gearing ratio may beadjustable so that the operator can control the resolution of theworking ends of the surgical instrument(s).

The master handles may include various sensors to provide feedback tothe surgeon relating to various tissue parameters or conditions, e.g.,tissue resistance due to manipulation, cutting or otherwise treating,pressure by the instrument onto the tissue, tissue temperature, tissueimpedance, etc. As can be appreciated, such sensors provide the surgeonwith enhanced tactile feedback simulating actual operating conditions.The master handles may also include a variety of different actuators fordelicate tissue manipulation or treatment further enhancing thesurgeon's ability to mimic actual operating conditions.

Referring to FIG. 51, a medical work station is shown generally as workstation 1000 and generally may include a plurality of robot arms 1002,1003; a control device 1004; and an operating console 1005 coupled withcontrol device 1004. Operating console 1005 may include a display device1006, which may be set up in particular to display three-dimensionalimages; and manual input devices 1007, 1008, by means of which a person(not shown), for example a surgeon, may be able to telemanipulate robotarms 1002, 1003 in a first operating mode.

Each of the robot arms 1002, 1003 may include a plurality of members,which are connected through joints, and an attaching device 1009, 1011,to which may be attached, for example, a surgical tool “ST” supportingan end effector 1100, in accordance with any one of several embodimentsdisclosed herein, as will be described in greater detail below.

Robot arms 1002, 1003 may be driven by electric drives (not shown) thatare connected to control device 1004. Control device 1004 (e.g., acomputer) may be set up to activate the drives, in particular by meansof a computer program, in such a way that robot arms 1002, 1003, theirattaching devices 1009, 1011 and thus the surgical tool (including endeffector 1100) execute a desired movement according to a movementdefined by means of manual input devices 1007, 1008. Control device 1004may also be set up in such a way that it regulates the movement of robotarms 1002, 1003 and/or of the drives.

Medical work station 1000 may be configured for use on a patient 1013lying on a patient table 1012 to be treated in a minimally invasivemanner by means of end effector 1100. Medical work station 1000 may alsoinclude more than two robot arms 1002, 1003, the additional robot armslikewise being connected to control device 1004 and beingtelemanipulatable by means of operating console 1005. A medicalinstrument or surgical tool (including an end effector 1100) may also beattached to the additional robot arm. Medical work station 1000 mayinclude a database 1014, in particular coupled to with control device1004, in which are stored, for example, pre-operative data frompatient/living being 1013 and/or anatomical atlases.

Reference is made herein to U.S. Pat. No. 8,828,023, entitled “MedicalWorkstation,” the entire content of which is incorporated herein byreference, for a more detailed discussion of the construction andoperation of an exemplary robotic surgical system.

It is contemplated, and within the scope of the present disclosure, thatother endoscopic assemblies, including a pair of jaws having a uniqueand diverse closure stroke length thereof, may be provided with a driveassembly, similar to any of the drive assemblies described herein, foraccommodating and adapting the closure stroke length for the pair ofjaws thereof to the constant trigger stroke length.

Accordingly, various endoscopic assemblies, constructed in accordancewith the principles of the present disclosure, may be provided which arealso capable of firing or forming or closing surgical clips of varioussizes, materials, and configurations, across multiple platforms formultiple different manufactures.

It should be understood that the foregoing description is onlyillustrative of the present disclosure. Various alternatives andmodifications can be devised by those skilled in the art withoutdeparting from the disclosure. Accordingly, the present disclosure isintended to embrace all such alternatives, modifications and variances.The embodiments described with reference to the attached drawing figuresare presented only to demonstrate certain examples of the disclosure.Other elements, steps, methods and techniques that are insubstantiallydifferent from those described above and/or in the appended claims arealso intended to be within the scope of the disclosure.

What is claimed is:
 1. A reposable surgical clip applier, comprising: ahandle assembly; and an endoscopic assembly selectively connectable toand in mechanical communication with the handle assembly, the endoscopicassembly including a shaft assembly having: an outer tube defining alongitudinal axis extending therealong and a pair of transverse channelsformed therein; a pusher bar slidably supported within the outer tube,wherein a proximal portion of the pusher bar is received within the pairof transverse channels; and a spindle assembly slidably supported withinthe outer tube, a surface of the spindle supporting a fin that is inselective engagement with a proximal portion of the pusher bar, whereinduring a distal advancement of the spindle, the fin urges the pusher barin a distal direction.
 2. The reposable surgical clip applier accordingto claim 1, wherein each of the pair of transverse channels defines asubstantially U-shaped profile.
 3. The reposable surgical clip applieraccording to claim 2, wherein a proximal portion of each of the pair oftransverse channels defines a first portion that extends in anorthogonal orientation with respect to the longitudinal axis of theouter tube.
 4. The reposable surgical clip applier according to claim 3,wherein each of the pair of transverse channels defines a second portionadjacent to the first portion, the second portion extending in aparallel orientation relative to the longitudinal axis of the outertube.
 5. The reposable surgical clip applier according to claim 4,wherein during an initial distal advancement of the spindle, the pusherbar translates in a horizontal direction within the second portion ofthe pair of transverse channels.
 6. The reposable surgical clip applieraccording to claim 5, wherein during continued distal advancement of thespindle, the pair of transverse channels cams the pusher bar in adirection away from the longitudinal axis of the outer tube to followthe oblique orientation of the third portion of the pair of transversechannels.
 7. The reposable surgical clip applier according to claim 6,wherein when the pusher bar is in a distal most position, the findisengages from the pusher bar, permitting the spindle to advance in adistal direction separate from the pusher bar.
 8. The reposable surgicalclip applier according to claim 4, wherein each of the pair oftransverse channels defines a third portion adjacent to the secondportion, the third portion defining an oblique angle with respect to thelongitudinal axis of the outer tube.
 9. The reposable surgical clipapplier according to claim 1, wherein the pusher bar includes atransverse pin disposed on a proximal portion thereof, the transversepin configured to slidably engage the pair of transverse channels. 10.The reposable surgical clip applier according to claim 1, wherein aproximal portion of the pusher bar defines an arm forming an obliqueangle with respect to a second longitudinal axis defined by the pusherbar.
 11. The reposable surgical clip applier according to claim 1,further comprising a biasing element, a first end of the biasing elementbeing coupled to the pusher bar and a second end of the biasing elementbeing coupled to the outer tube, wherein the biasing element isconfigured to bias the pusher bar in a proximal direction.
 12. Anendoscopic assembly for use with a reposable surgical clip applier, theendoscopic assembly comprising: an outer tube defining a longitudinalaxis extending therealong, and a pair of transverse channels formedtherein; a pusher bar slidably supported within the outer tube, whereina proximal portion of the pusher bar is received within the pair oftransverse channels; and a spindle assembly slidably supported withinthe outer tube, a surface of the spindle supporting a fin that is inselective engagement with a proximal portion of the pusher bar, whereinduring a distal advancement of the spindle, the fin urges the pusher barin a distal direction.
 13. The endoscopic assembly according to claim12, wherein each of the pair of transverse channels defines asubstantially U-shaped profile.
 14. The endoscopic assembly according toclaim 13, wherein a proximal portion of each of the pair of transversechannels defines a first portion that extends in an orthogonalorientation with respect to the longitudinal axis of the outer tube. 15.The endoscopic assembly according to claim 14, wherein each of the pairof transverse channels defines a second portion adjacent to the firstportion, the second portion extending in a parallel orientation relativeto the longitudinal axis of the outer tube.
 16. The endoscopic assemblyaccording to claim 15, wherein each of the pair of transverse channelsdefines a third portion adjacent to the second portion, the thirdportion defining an oblique angle with respect to the longitudinal axisof the outer tube.
 17. The endoscopic assembly according to claim 12,wherein the pusher bar includes a transverse pin disposed on a proximalportion thereof, the transverse pin configured to slidably engage thepair of transverse channels.
 18. The endoscopic assembly according toclaim 12, wherein a proximal portion of the pusher bar defines an armforming an oblique angle with respect to a second longitudinal axisdefined by the pusher bar.
 19. The endoscopic assembly according toclaim 12, further comprising a biasing element, a first end of thebiasing element being coupled to the pusher bar and a second end of thebiasing element being coupled to the outer tube, wherein the biasingelement is configured to bias the pusher bar in a proximal direction.20. The endoscopic assembly according to claim 12, wherein when thepusher bar is in a distal most position, the fin disengages from thepusher bar, permitting the spindle to advance in a distal directionseparate from the pusher bar.